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Framework for evaluating measures to control nosocomial tuberculosis transmission.

Authors
Nazaroff-WW; Nicas-M; Miller-SL
Source
Indoor Air 1998 Jan; 8:205-218
NIOSHTIC No.
20024408
Abstract
Diverse control measures can be applied to reduce tuberculosis infection risk in health-care facilities. Selecting optimal controls requires methods for predicting the dependence of infections risk on underlying parameters. A common model for infection risk only explicitly accounts for control by ventilation. This paper proposes a more complete model for evaluating tuberculosis infection control methods in health-care settings. An infection risk parameter is defined as the probable number of infectious droplet nuclei inhaled by all susceptible persons from a single infectious person. Algebraic model equations are presented for two exposure cases. In one, the susceptible and infectious persons are together in a well-mixed indoor environment; in the second, the infectious person is in respiratory isolation. Model equations are used to explore many common tuberculosis control measures: identification, isolation and treatment of tuberculosis cases; surgical masks and treatment booths applied at the source; environmental controls such as ventilation, air filtration, and ultraviolet germicidal irradiation; and respiratory protection for susceptible persons. Experimental data are limited or lacking on some key variables, such as emissions of infectious droplet nuclei by contagious persons and air leakage rates from isolation rooms. Methods are outlined for collecting additional data.
Keywords
Infectious-diseases; Infection-control; Disease-transmission; Disease-incidence; Disease-control; Risk-analysis; Risk-factors; Health-care-personnel; Engineering-controls; Occupational-health; Health-care-facilities; Environmental-control; Environmental-factors; Respiratory-protection; Filtration
Contact
Center for Occupational and Environmental Health, School of Public Health, 140 Warren Hall, University of California, Berkeley, CA 94720
CODEN
INAIE5
Publication Date
19980101
Document Type
Journal Article
Funding Amount
161775
Funding Type
Grant
Fiscal Year
1998
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-K01-OH-000155
ISSN
0905-6947
Priority Area
Research Tools and Approaches: Risk Assessment Methods
Source Name
Indoor Air
State
CA
Performing Organization
University of California-Berkeley, School of Public Health, Center for Occupational and Environmental Health, Berkeley, CA 94720
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